Firearm Owners' Preferences for Locking Devices: Results of a National Survey
Authors: Marian E. Betz, Ian H. Stanley, Jessica Buck-Atkinson, Rachel Johnson, Craig J. Bryan, Justin C. Baker, AnnaBelle O. Bryan, Kyleanne Hunter, Michael D. Anestis
Journal: Annals of Internal Medicine (2023)

LettersMarch 2023Firearm Owners' Preferences for Locking Devices: Results of a National SurveyFREEMarian E. Betz, MD, MPH, Ian H. Stanley, PhD, Jessica Buck-Atkinson, MPH, Rachel Johnson, MS, Craig J. Bryan, PsyD, Justin C. Baker, PhD, AnnaBelle O. Bryan, MS, Kyleanne Hunter, PhD, Michael D. Anestis, PhDMarian E. Betz, MD, MPHDepartment of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Firearm Injury Prevention Initiative, University of Colorado Anschutz Medical Campus, and VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, Colorado, Ian H. Stanley, PhDFirearm Injury Prevention Initiative and Center for COMBAT Research, Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, Jessica Buck-Atkinson, MPHFirearm Injury Prevention Initiative, University of Colorado Anschutz Medical Campus, Aurora, Colorado, Rachel Johnson, MSDepartment of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, Craig J. Bryan, PsyDDepartment of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, Ohio, Justin C. Baker, PhDDepartment of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, Ohio, AnnaBelle O. Bryan, MSDepartment of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, Ohio, Kyleanne Hunter, PhDRAND Corporation, Santa Monica, California, Michael D. Anestis, PhDNew Jersey Gun Violence Research Center, Rutgers School of Public Health, Rutgers University, Piscataway, New JerseyAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-3113 SectionsSupplemental MaterialAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Secure home storage of firearms may reduce suicide and injury risk (1). Providing locking devices may increase secure firearm storage practices (2–4), but questions remain about which devices motivate secure storage.Objective: To describe preferences about personal firearm locking devices among firearm-owning adults living in the United States.Methods: We hired the Ipsos research firm for a brief (8-minute) online survey (28 July to 8 August 2022). Ipsos drew a sample from its KnowledgePanel, a probability-based, nationally representative, online panel of English-speaking, noninstitutionalized adults (aged ≥18 years) described elsewhere (5). Eligible survey participants were U.S. adults owning at least 1 firearm, excluding active-duty military personnel. Participants received incentives through KnowledgePanel; the Colorado Multiple Institutional Review Board approved study procedures.Questions, accompanied by device photos, examined relative preferences for various firearm locking devices (Supplement). KnowledgePanel data included demographic and household characteristics.Descriptive analyses (weighted proportions with 95% CIs) were computed using the weighting variable provided by Ipsos and weighting commands in R, version 4.2.0 (R Foundation), using the survey package. Ipsos adjusts survey weights after sampling through iterative proportional fitting to minimize nonresponse bias and ensure that the sample is nationally representative. Study-specific poststratification weights adjusted for nonresponse, demographic distributions (from the American Community Survey or Current Population Survey), and KnowledgePanel benchmarks for adult gun owners.Findings: Among 4081 firearm owners invited, 2152 completed the survey (53% participation) (Table). Respondents mostly identified as non-Hispanic White (75.6% [95% CI, 73.3% to 77.8%]) and male (66.7% [CI, 64.3% to 69.0%]). Most (64.8% [CI, 62.5% to 67.1%]) owned both handguns (mean, 3.7 handguns) and long guns (mean, 4.5 long guns). Most participants (70.8% [CI, 68.7% to 72.9%]) used at least 1 form of storage or locking device for at least 1 firearm; 65.3% (CI, 62.9% to 67.5%) had 1 or more unlocked firearms.Table. Demographic and Firearm-Related Characteristics of Adult Firearm Owners (n = 2152)The top considerations about the selection of firearm locking device related to speed (57.4% [CI, 55.0% to 59.7%]) and ease (49.4% [CI, 47.0% to 51.8%]) of access, followed by cost (33.0% [CI, 30.8% to 35.3%]), strength or security (30.4% [CI, 28.2% to 32.6%]), and compatibility with personally owned firearms (25.3% [CI, 23.3% to 27.4%]) (Table). Participants were asked to imagine being "at a community event and a nonpolitical group is giving out free firearm locking devices. You don't need to provide your name or contact information to get a device." When queried what 1 device they would choose, 40.9% (CI, 38.5% to 43.3%) selected a device using a key, personal identification number (PIN), or dial and 41.9% (CI, 39.4% to 44.3%) chose a biometric device. The remainder chose a coupon toward a purchase of a gun safe, cabinet, or other large locking device (Table), but 80.0% said the coupon would need to be for at least 25% off. The most popular device choices were a biometric in-vehicle lock (17.1% [CI, 15.2% to 19.1%]) or a trigger lock using a key, PIN, or dial (12.2% [CI, 10.7% to 13.8%]). Participants were asked what locking devices they would consider buying at the same community event and how much they would pay. Participants' top choices were small lock boxes using a key, PIN, or dial (58.4% [CI, 56.0% to 60.7%]; mean, $60 [CI, $44 to $76]) and biometric in-vehicle locks (57.2% [CI, 54.8% to 59.5%]; mean, $87 [CI, $71 to $103]) (Figure).Figure. Weighted proportion of firearm owners who would consider purchasing various locking devices at a community event and, among those who would, weighted mean amount willing to pay (n = 2152).Proportions and means are weighted. Bars show 95% CIs. Amounts are shown in U.S. dollars. Approximate retail prices (January 2023) are as follows; prices were not given to participants. Key/PIN/dial devices: cable lock, $5–$20; clamshell, $5–$50; trigger lock, $5–$50; small lock box, $20–$300; in-vehicle lock, $20–$300. Biometric devices: cable lock, $50; clamshell, $60–$2000; trigger lock, $60–$2000; small lock box, $60–$2000; in-vehicle lock, $60–$2000. PIN = personal identification number. Download figure Download PowerPoint Discussion: This nationally representative survey of firearm owners found varied preferences about firearm locking devices. Of note, only 11% of respondents said that they would choose a keyed cable lock over other options, and many participants preferred in-vehicle locking devices or biometric devices. Low-cost and lightweight keyed cable locks are often provided by health care, public health, and community programs, but our findings suggest that offering a broader range of devices—or financial incentives—may enhance uptake; this approach may require additional financial support for programs. Many participants indicated an interest in coupons to offset the cost of purchasing a larger locking device like a gun safe, suggesting additional avenues for injury prevention partnerships (for example, with device manufacturers and resellers).This survey included only English-speaking firearm owners, so results may not generalize. We did not ask how many devices respondents would want for free or purchase at community events, nor about their perceptions of the actual retail cost of various devices. Acceptability bias may have resulted in overreporting of interest in locking devices.Despite these limitations, this study highlights the varied preferences for locking devices, which can directly inform health care– and community-based programs to provide free or discounted devices. Further work should examine the relative security of varied devices and whether providing a choice of locking device, compared with not, is more likely to prompt behavior change.References1. Grossman DC, Mueller BA, Riedy C, et al. Gun storage practices and risk of youth suicide and unintentional firearm injuries. JAMA. 2005;293:707-14. [PMID: 15701912] CrossrefMedlineGoogle Scholar2. Roszko PJ, Ameli J, Carter PM, et al. Clinician attitudes, screening practices, and interventions to reduce firearm-related injury. Epidemiol Rev. 2016;38:87-110. [PMID: 26905894] doi:10.1093/epirev/mxv005 CrossrefMedlineGoogle Scholar3. Stuber JP, Massey A, Meadows M, et al. SAFER brief community intervention: a primary suicide prevention strategy to improve firearm and medication storage behaviour. Inj Prev. 2021;27:428-434. [PMID: 33082159] doi:10.1136/injuryprev-2020-043902 CrossrefMedlineGoogle Scholar4. Anestis MD, Bryan CJ, Capron DW, et al. Lethal means counseling, distribution of cable locks, and safe firearm storage practices among the Mississippi National Guard: a factorial randomized controlled trial, 2018-2020. Am J Public Health. 2021;111:309-317. [PMID: 33351652] doi:10.2105/AJPH.2020.306019 CrossrefMedlineGoogle Scholar5. Betz ME, Azrael D, Barber C, et al. Public opinion regarding whether speaking with patients about firearms is appropriate: results of a national survey. Ann Intern Med. 2016;165:543-550. [PMID: 27455516] doi:10.7326/M16-0739 LinkGoogle Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAuthors: Marian E. Betz, MD, MPH; Ian H. Stanley, PhD; Jessica Buck-Atkinson, MPH; Rachel Johnson, MS; Craig J. Bryan, PsyD; Justin C. Baker, PhD; AnnaBelle O. Bryan, MS; Kyleanne Hunter, PhD; Michael D. Anestis, PhDAffiliations: Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Firearm Injury Prevention Initiative, University of Colorado Anschutz Medical Campus, and VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, ColoradoFirearm Injury Prevention Initiative and Center for COMBAT Research, Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, ColoradoFirearm Injury Prevention Initiative, University of Colorado Anschutz Medical Campus, Aurora, ColoradoDepartment of Biostatistics and Informatics, Colorado School of Public Health, Aurora, ColoradoDepartment of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OhioRAND Corporation, Santa Monica, CaliforniaNew Jersey Gun Violence Research Center, Rutgers School of Public Health, Rutgers University, Piscataway, New JerseyDisclaimer: The contents of this work are the authors' sole responsibility and do not necessarily represent the official views of any of the authors' or contributors' funders or employers.Financial Support: By RESTORAL funds award ID07200010-301 from the Defense Health Agency of the Department of Defense.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-3113.Reproducible Research Statement: Study protocol and data set: Available from Dr. Betz (e-mail, marian.betz@cuanschutz.edu). Statistical code: Available from Ms. Johnson (e-mail, rachel.johnson@cuanschutz.edu).Corresponding Author: Marian E. Betz, MD, MPH, University of Colorado Anschutz Medical Campus, 13001 East 17th Place B119, Aurora, CO 80045; e-mail, marian.betz@cuanschutz.edu.This article was published at Annals.org on 7 February 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAssessment of Firearm Storage Practices in the US, 2022 March 2023Volume 176, Issue 3Page: 424-427KeywordsFirearm injuriesPrevention, policy, and public healthSuicide ePublished: 7 February 2023 Issue Published: March 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...